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Introduction The Procedure Before the catheterization procedure, the doctor usually will meet with the patient to perform an examination, ask about the patient's medical history, and discuss the procedure and its risks. In many cases, he or she will discuss the possibility of performing an angioplasty at the same time the catheterization is done, should the procedure reveal one or more blockages that require immediate treatment. These procedures typically are referred to as a "cath possible" or "on-line" angioplasty. Blood tests, including tests of the patient's blood counts and kidney function, and an electrocardiogram (EKG) usually are performed on the morning of the scheduled catheterization, although some physicians prefer to do these tests several days before the procedure. On the morning of the procedure, the patient typically is connected to an intravenous (IV) line to allow for the administration of fluids, to avoid dehydration, and for the administration of medications, if needed. Most patients are given a Valium-type sedative before the procedure, either in pill form or intravenously, to relax them and keep them as comfortable as possible while the cardiac catheterization is being performed. Patients who do not receive a sedative should feel free to ask the nurse or doctor for one; similarly, if the sedative dosage does not seem to relieve anxiety, the patient should ask for an additional dosage. Relaxation Pictures of the left ventricle taken during its "relaxation" and "contraction" phases are shown in Figure on this page. The arrows indicate how the ventricle walls have contracted to pump blood out of the left ventricle. Additional information also may be obtained during the cardiac catheterization. A second pencil-sized plastic sheath may be inserted through a vein in the groin to accommodate another catheter. This can be threaded up to and through several of the chambers of the heart to measure pressures in different parts of the heart. It also can be used to measure the amount of blood that the heart pumps each minute. Doctors refer to this procedure as a "right heart catheterization." Risk Factors The risks of cardiac catheterization are low, but sound medical reason should always determine whether to undergo a cardiac catheterization procedure. Although cardiac catheterization is regarded as a relatively safe procedure, complications do occasionally occur. These can include: •Bleeding at the site of sheath insertion. This commonly produces a small bruise in the groin, but, in rare cases, can lead to more serious internal bleeding. •Infection at the site of sheath insertion •Damage to the Blood Vessels to the groin •Allergic reaction to the iodine-based dye •Kidney damage and/or Kidney failure •Stroke •Heart attack •Death The Procedure Before the catheterization procedure, the doctor usually will meet with the patient to perform an examination, ask about the patient's medical history, and discuss the procedure and its risks. In many cases, he or she will discuss the possibility of performing an angioplasty at the same time the catheterization is done, should the procedure reveal one or more blockages that require immediate treatment. These procedures typically are referred to as a "cath possible" or "on-line" angioplasty. Blood tests, including tests of the patient's blood counts and kidney function, and an electrocardiogram (EKG) usually are performed on the morning of the scheduled catheterization, although some physicians prefer to do these tests several days before the procedure. On the morning of the procedure, the patient typically is connected to an intravenous (IV) line to allow for the administration of fluids, to avoid dehydration, and for the administration of medications, if needed. Most patients are given a Valium-type sedative before the procedure, either in pill form or intravenously, to relax them and keep them as comfortable as possible while the cardiac catheterization is being performed. Patients who do not receive a sedative should feel free to ask the nurse or doctor for one; similarly, if the sedative dosage does not seem to relieve anxiety, the patient should ask for an additional dosage. Assessment – Question 1: Which of the following types of medicines can be administered for lowering the level of LDL cholesterol and reduce the risk of heart attacks? Statins Antibiotics Antibiotics Beta-adrenergic Receptors Topical Assessment – Question 2: To lower your blood cholesterol level you should eat less saturated fat, total fat, and cholesterol, and lose weight if you are overweight. Assessment – Question 3: The best way to treat and control high blood pressure is? Control your weight Eat less salt (sodium) Eat more fruits and vegetables Reduce physical activity